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Case Reports
. 2024 May 6;45(3):808-810.
doi: 10.1093/jbcr/irae026.

Bone and Skin/Subcutaneous Tissue Concentrations of Cefiderocol During Treatment of Extensively Drug-Resistant Pseudomonas aeruginosa

Scott W Mueller  1 , Kyle C Molina  2 , Brittany Blass  3 , Cameron Gibson  3 , Amber D Kohler  3 , Martin Krsak  4 , Arek J Wiktor  3
Affiliations
Case Reports

Bone and Skin/Subcutaneous Tissue Concentrations of Cefiderocol During Treatment of Extensively Drug-Resistant Pseudomonas aeruginosa

Scott W Mueller et al. J Burn Care Res. .

Abstract

Pyoderma gangrenosum is a rare dermatologic disorder that disrupts the skin barrier, requiring immunosuppressive therapy. We successfully used cefiderocol for the treatment of an extensively drug-resistant Pseudomonas aeruginosa bacteremia, and presumed osteomyelitis in a patient with severe pyoderma gangrenosum and associated immunosuppressive therapy while being medically optimized for skin grafting. We obtained bone and skin/subcutaneous tissue while the patient was on cefiderocol under an institutional review board-approved biologic waste recovery protocol. Cefiderocol concentrations in bone and skin/subcutaneous tissue were 13.9 and 35.9 mcg/g, respectively. The patient recovered from bacteremia and underwent autografting without further complications. Cefiderocol at approved dosing of 2 g IV (3-hour infusion) every 8 hours resulted in bone and skin/subcutaneous tissue concentrations adequate to treat extensively drug-resistant Gram-negative bacteria that remain susceptible to cefiderocol.

Keywords: bone; cefiderocol; concentration; penetration; skin/subcutaneous tissue.

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Conflict of interest statement

K.M. is a member of the speakers’ bureau at Shionogi, Inc.; S.W.M. is a scientific counsel consultant for Shionogi, Inc. Other authors report no other relevant conflicts of interest.

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